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. 2014 Oct;12(4):299-305.
doi: 10.5217/ir.2014.12.4.299. Epub 2014 Oct 27.

Long-Term Clinical Outcome of Clostridium difficile Infection in Hospitalized Patients: A Single Center Study

Young Seok Doh  1 , You Sun Kim  1 , Hye Jin Jung  1 , Young Il Park  1 , Jin Won Mo  1 , Hyun Sung  1 , Kyung Jin Lee  1 , Young Ki Seo  1 , Jeong Seop Moon  1 , Seong Woo Hong  2
Affiliations

Long-Term Clinical Outcome of Clostridium difficile Infection in Hospitalized Patients: A Single Center Study

Young Seok Doh et al. Intest Res. 2014 Oct.

Abstract

Background/aims: Antibiotic usage and increasingly aging populations have led to increased incidence of Clostridium difficile infection (CDI) in worldwide. Recent studies in Korea have also reported increasing CDI incidence; however, there have been no reports on the long-term outcomes of CDI. We therefore investigated the long-term clinical outcomes of patients with CDI, including delayed recurrence, associated risk factors and mortality.

Methods: Hospitalized patients diagnosed with CDI at Seoul Paik Hospital between January 2007 and December 2008 were included. Their medical records were retrospectively investigated. 'Delayed recurrence' was defined as a relapse 8 weeks after a successful initial treatment. Multivariate logistic regression analysis was performed to identify risk factors for the delayed recurrence. Kaplan-Meier curves were used to analyze mortality rates.

Results: A total of 120 patients were enrolled; among them, 87 were followed-up for at least 1 year, with a mean follow-up period of 34.1±25.1 months. Delayed recurrence was observed in 17 patients (19.5%), and significant risk factors were age (over 70 years, P=0.049), nasogastric tube insertion (P=0.008), and proton pump inhibitor or H2-blocker treatments (P=0.028). The 12- and 24-month mortality rates were 24.6% and 32.5%, respectively. No deaths were directly attributed to CDI.

Conclusions: Delayed recurrence of CDI was not rare, occurring in 19.5% of the study population. Although CDI-related mortality was not reported, 2-year (32.5%) mortality rate of CDI patients implies that a CDI diagnosis may predict severe morbidity and poor prognosis of the underlying disease.

Keywords: Clostridium difficile; Mortality; Recurrence; Risk factors.

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Conflict of interest statement

Conflict of interest: None.

Figures

Fig. 1
Fig. 1
Kaplan-Meier curve of delayed recurrence in patients with Clostridium difficile infection.
Fig. 2
Fig. 2
Kaplan-Meier survival curve in patients with Clostridium difficile infection.
See this image and copyright information in PMC

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